Neuropsychiatry
(London)

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Abstract

Insomnia and self-destructiveness in adolescence: A French psychoanalytic perspective

Sleep disorders are the focus of numerous physiological, psychological and psychiatric studies, most of which are based on cognitive, behavioral and developmental models. The psychoanalytic model is not often used in contemporary research, in spite of the fact that dreams are central in psychoanalysis. This article aims to heighten awareness to the relevance of psychoanalytic perspectives in the research on sleep disorders. Indeed, the complexity of sleep disorders calls for a confrontation between different health disciplines and specialties. Adolescence is a particularly sensitive period and complaints of sleep disturbance frequent.

Even though physical, hormonal and behavioral changes have an undeniable impact on sleep, we underscore the importance of exploring the intrapsychic conflicts characteristic of this period. The resurgence of sexual and aggressive impulses must to be worked through in order to fully understand the underpinnings of disturbed sleep. Based on research we are conducting at present, we first focus on the regression that takes place during sleep, with its corollary, passivity. We find that adolescents prone to sleep disturbances resist the passive position that comes with regression. We then show how this resistance to passivity is linked to a difficulty in expressing internalized aggressiveness and how the excessive retention and repression of these affects can transform them into destructiveness and self-destructive behavior.

Sleep has a constructive and organizing function that is essential to dreaming, and dreaming is a container for the symbolization of sexual and aggressive fantasies. Sleep disorders hinder this symbolization and thus, the processing of intrapsychic conflicts. Working through these conflicts is however necessary, as otherwise they re-emerge and disturb sleep. This vicious cycle amplifies the self-destructive impact of sleep disorders. Lastly, we underscore the fear of death that is linked to sleep disorders and the unconscious associations between death and sleep.